Kidney stones affect approximately 1 in 11 individuals in the United States. The 2012 National Health and Nutrition and Examination Survey (NHANES), part of the Urological Diseases in America Project, reported that the overall prevalence of kidney stones was 8.8% (10.6% and 7.1% for men and women, respectively) (Jiang et al., Am J Physiol Gastrointest Liver Physiol 302, G637-643, 2012). This study and others attest to the significant increase in stone cases in general, but especially in individuals with obesity, diabetes, and following bariatric surgery (Jiang et al., supra; Knight et al., Am J Nephrol 25, 171-175, 2005). The direct and indirect costs associated with kidney stone treatment (i.e., nephrocalcinosis) are significant (Knight et al., Kidney Int 70, 1929-1934, 2006).
Individuals with Primary Hyperoxaluria (PH) have mutations in a variety of genes involved in glyoxylate and hydroxyproline (Hyp) metabolism that result in a significant increase in oxalate production and deposition of calcium oxalate stones, the most common type of stones for all stone formers. The treatments for these individuals range from a combined kidney-liver transplant to a life-long use of potassium citrate, increased fluid intake and dietary restriction of oxalate (Riedel et al., PLoS One 6, e26021, 2011; Knight et al., Am J Physiol-Renal 302, F688-693, 2012). Treatments for the removal of stones currently include shock-wave lithotripsy, ureteroscopic stone removal, and percutaneous nephrolithotomy (Riedel et al., supra). However, the recurrence of stones following the available procedures is over 50%.
Kidney stones are also a significant problem in veterinary medicine. Pets such as dogs and cats can develop stones that lead to painful urination and/or a life-threatening blockage.
Considering that the current treatments only address symptoms, novel treatments to prevent or control the formation of stones in PH and other idiopathic stone formers are greatly needed.